Schlüsselwörter

Vaginal reconstruction

Abstract

Pathological alterations to the vulva and vagina are typical gynecological diseases in all phases of life in women, which can be associated with a severe impairment of body integrity and sexuality. Oncological indications for vaginal reconstruction are rare and are mostly necessary in cases of gynecological oncological operations of the true pelvis due to cervical, uterine, vaginal and vulvar cancer or spreading of urinary bladder or rectal carcinomas to other organs during an exenteration. Various abdominal and vaginal techniques can be used to form a new vagina-like hollow organ with the possibility of vaginal cohabitation. From the abdominal side portions of the large intestines can be used for a sigmoid or ileocecal neovagina; however, in the oncological concept this must be individually coordinated with maintaining the integrity of urinary and fecal drainage. The morbidity of these invasive techniques must be meticulously estimated and carried out by an interdisciplinary team in centers with high expertise. A concept must be constructed for each patient by weighing up the wishes for reconstruction of an intact self-image and the operative risks with gut resection and reconstruction against the prospect of a limited life expectation in cases of an advanced cancerous disease. From the vaginal side after simple colpectomy mostly the technique of a mesh graft neovagina can be used with reduced morbidity and good long-term results.